India is in the midst of a smoking epidemic which will kill about a million people annually - or cause nearly one out of every ten deaths - during the 2010s, researchers said.
And some 70 percent of those people will die before they reach the age of 70, according to the study the published in the New England Journal of Medicine.
"I am alarmed by the results of this study," India's Health Minister Abumani Ramadoss said in a statement. "The government of India is trying to take all steps to control
tobacco use - in particular by informing the many poor and illiterate of smoke risks."
The first nationally representative study of smoking habits and associated mortality rates found that some 120 million Indians smoke, although they generally pick up the habit later in life. Some 37 percent of men and about five percent of women aged 30 to 69 smoke either cigarettes or leaf-wrapped bidis, which are unfiltered and contain about a quarter as much tobacco as a cigarette.
How the study was done
The study projected that smoking will cause one in five deaths of Indian males and one in 20 deaths of Indian females aged 30 to 69 in the coming decade.
Men who smoked cigarettes lost an average of ten years of life, while smoking bidis cut an average of six years off the life expectancy of men and eight years off of the lives of women.
Even light smokers saw their mortality risk jump: smoking between one and seven cigarettes a day nearly doubled the mortality risk while smoking the equivalent number of bidis raised mortality risks by a third.
"It is truly remarkable that one single factor, namely smoking, which is entirely preventable, accounts for nearly one in ten of all deaths in India," said Nobel Laureate Amartya Sen. "The study brings out forcefully the need for immediate public
action in this much neglected field."
'Extreme risks surprising'
Indian, Canadian and British researchers led a team of 900 field workers who surveyed all adult deaths during 2001-2003 in a nationally representative sample of 1.1 million homes in all parts of India.
Researchers compared the smoking histories of 74 000 adults who had died with 78 000 living controls and adjusted their findings based on education levels, alcohol use and whether they lived in rural or urban areas.
They found about 61 percent of men who smoked died between the ages of 30 and 69 compared with only 41 percent of non-smokers with similar backgrounds. Some 62 percent of women who smoked died in middle age, compared with only 38 of non-smokers.
"The extreme risks from smoking that we found surprised us, as smokers in India start at a later age than those in Europe or America and smoke less," said lead author Prabhat Jha of the University of Toronto's Centre for Global Health Research.
"And, smoking kills not only from diseases like cancer and lung diseases, but also from tuberculosis and heart attacks." Quitting smoking has been shown to greatly reduce the mortality risk. But it is an uncommon phenomenon in India, where only about two percent of adults have quit, and they often did so only after they had fallen ill, the study found. – (Sapa)
- February 2008
Tobacco may kill 1 billion
Hand-rolled smokes unhealthier